Completed declarations of interest

Important: Members of the Board Please;

1 . Read the notes before completing each section of the form

2. Remember that the interests to be notified include those of your spouse/partner as detailed on page 1 of the notes (these will not be shown separately on the website that displays the public register)

3. Write Clearly

4. Do NOT include any abbreviations or acronyms

5. Ensure that you enter "None" in any of the boxes under headings where there is nothing to be registered

6. Ensure that you sign and date the notification

7. Remember to keep your register of interests up to date, as this is a legal duty. Inform the MO when your interests change and complete a new form if required to do so.

8. A form must be completed within 28 days. It is a criminal offence to fail to register interests in accordance with the Localism Act 2011

9. Complete this document with reference and in conjunction with the Code of Conduct and Declarations of Interests Policy

Blank form

The blank form templates asks for information for the Board member and their Spouse, civil partner or equivalent to be listed separately. Text of the form as below. 

Register of Interests

I [insert name], (role) of the Pride in Place Board, give notice that I have set out below the Disclosable Pecuniary Interests which are required to be notified to the Monitoring Officer further to the provisions of the Localism Act 2011 and The Relevant Authorities (Disclosable Pecuniary Interests) Regulations, and other registerable interests as required by my code of conduct.

Consent for storing submitted data: (tick boxes)

I give permission to store and process my data.

No, I do not consent to storing and processing my data.

Part A

1. Employment, office, trade, profession or vocation

2. Sponsorship

3. Contracts

4. Land and Property

5. Licences

6. Corporate tenancies

7. Securities

8. Gifts or Hospitality worth an estimated value of £50 or more

Part B

Other Registerable Interests-please see the note for explanation

Your declaration

I wish to declare the following interests that conflict or may be perceived to conflict with my duties as a Member of the Board and agree not to take part in any Board decisions or recommendations affected by this interest. If you have no such interests, please state "nil."

[Sign and date]

Notes and Guidance

Whose interests must be included

The Act provides that the interests which must be notified are those of a member or co-opted member of the authority, or

• those of a spouse or civil partner of the member or co-opted member      

• those of a person with whom the member or co-opted member is living as husband/wife

• those of a person with whom the member or co-opted member is living as if they were civil partners

•  in each case where the member or co-opted member is aware that the other person has the interest.

Part A — Disclosable Pecuniary Interests

Section 1: Employment etc.

You must include details of, "any employment, office, trade, profession or vocation carried on for profit or gain". Please ensure that:

• you include a short description of the activity concerned: for example, "Computer Operator" or "Accountant"

• you give the name of any employer, e.g. the company which pays your salary or wages where an office is held, the name of the person or body who made the appointment is given

Please note that:

• the Monitoring Officer does not consider that receiving a basic or special responsibility allowance further to Pride in Place duties to be a disclosable pecuniary interest  

• there is no need to enter (as examples) "retired" or "retired doctor' — if there is nothing which applies to you or your spouse/partner under this section, please simply enter "None".

Section 2: Sponsorship

You must include details of, "any payment or provision of any other financial benefit (other than from the Pride in Place of which you are a member or co- opted member) made or provided within the relevant period in respect of any expenses incurred by you in carrying out your duties as a member. (The "relevant period" being the period of twelve months ending with the day when you make a notification). This includes any payment or financial benefit from a trade union within the meaning of the Trade Union and Labour Relations (Consolidation) Act 1992." Please note:

• the time period mentioned in the section "When should the monitoring officer be notified of disclosable pecuniary interests"

Section 3: Contracts

You must include details of, "any contract between you, or your spouse, civil partner or equivalent, or a body in which either of you have a beneficial interest, and the Pride in Place of which you are a member or co-opted member:

• under which goods or services are to be provided or works are to be executed; and

• which has not been fully discharged"

• A body in which you or your spouse, civil partner or equivalent have a beneficial interest means a firm in which you/they are a partner, or a body corporate of which you/they are a director, or in the securities of which you/they have a beneficial interest).

• Director' includes a member of the committee of management of an industrial and provident society.

Section 4: Land and Property

You must include details of,

"any land which is within the area of Pride in Place in which you or your spouse, civil partner or equivalent have a beneficial interest."

• Land excludes an easement, servitude, interest or right in or over land which does not carry with it a right for you or your spouse, civil partner or equivalent (alone or jointly with another) to occupy the land or to receive income.

Please ensure that:

• you give the address or a brief description to identify the land and property  

• if you live in the area of the Pride in Place of which you are a member or co-opted member, you include your home under this heading as owner, lessee or tenant

Please remember that:

• this provision is likely to include the address where you live  

• the requirement relates only to land in the area of the Pride in Place in respect of which you are making the notification

Section 5: Licences

You must include details of, "any land which is within the area of Pride in Place for which you or your spouse, civil partner or equivalent hold a licence (alone or jointly with others) to occupy for a month or longer."

Please ensure that you give the address or a brief description to identify the land.

Section 6: Corporate Tenancies

You must include details of, "any tenancy where (to your knowledge)  

• the landlord is the Pride in Place of which you are a member or co-opted member and;  

• the tenant is a body in which you or your spouse, civil partner or equivalent have a beneficial interest."

Please note:

• A body in which you or your spouse, civil partner or equivalent have a beneficial interest means a firm in which you/they are a partner, or a body corporate of which you/they are a director, or in the securities of which you/they have a beneficial interest.

•  "Director" includes a member of the committee of management of an industrial and provident society.

Section 7: Securities

You must include details of, "any beneficial interest of you or your spouse, civil partner or equivalent in securities of a body where:

That body (to your knowledge) has a place of business or land in the area of the Pride in Place of which you are a member or co-opted member, and either,

• the total nominal value of the securities exceeds €25,000 or one hundredth of the total issued share capital of that body; or   

• if the share capital of that body is of more than one class, the total nominal value of the shares of any one class in which you or your spouse, civil partner or equivalent have a beneficial interest exceeds one hundredth of the total issued share capital of that class."

Please note:

• "Securities" means shares, debentures, debenture stock, loan stock, bonds, units of a collective investment scheme within the meaning of the Financial Services and Markets Act 2000 and other securities of any description, other than money deposited with a building society

•  You do not have to show the extent of your interest.

Section 8-Gifts and Hospitality

Please register any gifts or hospitality offered, whether accepted or declined, with an estimated value of E50 or above. There is a separate form to complete for this, which will be supplied by the Monitoring Officer on request.

Part B-Other Registerable Interests

Section 9

In this section of the form, you are required to disclose

• any unpaid directorships  

• anybody of which you are a member or are in a position of general control or management and to which you are nominated or appointed by your authority  

• any body

  1. exercising functions of a public nature

  2. directed to charitable purposes or

  3. one of whose principal purposes includes the influence of public opinion or policy (including any political party or trade union) of which you are a member or in a position of general control or management